Is期睾丸混合性生殖细胞瘤不同治疗方法研究(附3例报告)

Treatments of stage-Is testicular mixed germ cell tumors: A report of 3 cases

目的：本文旨在探讨Is期睾丸混合性生殖细胞瘤的不同治疗方法。方法：对2008年2月至2012年6月收治3例（年龄26~39岁）入院的Is期睾丸混合性生殖细胞瘤患者的临床资料进行回顾性分析和总结,并结合文献就该期肿瘤的临床特征进行探讨。结果：3例患者中1例只行根治性睾丸切除术,1例行根治性睾丸切除术＋腹膜后淋巴结清扫术＋BEP方案化疗,1例行根治性睾丸切除术＋放疗。混合性生殖细胞瘤病理成分分别为左侧95%未成熟畸胎瘤、精原细胞瘤合并5%绒癌、胚胎性癌成分,左侧75%精原细胞瘤合并25%胚胎性癌、畸胎瘤成分,右侧90%成熟性畸胎瘤合并10%卵黄囊瘤。随访24个月3例患者肿瘤无局部复发和远处转移。结论：对于Is期睾丸混合性生殖细胞瘤诊断主要依靠体格检查、超声、MRI、血清肿瘤标记物测定等,确诊需要病理学检查,根治性睾丸切除术是其基础的治疗方法。

Objective： To investigate different treatment methods for stage-Is testicular mixed germ cell tumors（ TMGCTs）.Methods： We retrospectively analyzed the clinical data about 3 cases of stage-Is TMGCTs（ aged 26- 39 years） treated in the 175 th Hospital of PLA,reviewed relevant literature,and explored the clinical characteristics of TMGCTs. Results： Of the 3 patients,1 was treated by radical orchiectomy,1 by radical orchiectomy ＋ retroperitoneal lymph node dissection ＋ BEP chemotherapy scheme,and the other by radical orchiectomy ＋ radiotherapy. The pathological components of TMGCTs were immature teratoma,seminoma,spermatocytoma,chorioepithelioma,embryonal carcinoma,and yolk sac tumor. No recurrence or distant metastasis was found during the24-month follow-up after surgery. Conclusion： The diagnosis of TMGCTs primarily depends on physical examination,ultrasonography,MRI,and measurement of serum tumor markers,while its confirmation necessitates pathological examination,and its treatment is basically radical orchiectomy.